Gestational diabetes mellitus and life-course health

Gestational diabetes mellitus (GDM), traditionally defined as a disorder of hyperglycaemia with first onset or recognition during pregnancy, is a common condition which is complicated, costly, and controversial. Advances in understanding and awareness of GDM pathophysiology are resulting in an increasingly loud call for the application of personalised medicine approaches to both research in, and clinical care of, GDM. There is a shift away from viewing GDM as a condition to be diagnosed at 24 weeks of gestation and followed until 12 weeks postpartum, to a condition of metabolic vulnerability that precedes pregnancy, persists after pregnancy and requires a precision, life-course approach for health optimization facilitated by integrated, health system-wide supports. This article reviews emerging areas of focus in GDM with an emphasis on the relationship between the development of GDM and future health complications. The terms woman and women, mother and maternal are used in this paper to refer to all those, regardless of gender, who can or have become pregnant.